| NPI | 1649328014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP0162) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MN LP0162) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP0162) | |
| 103TC0700X Psychologist, Clinical (Licence: MN LP0162) | |
| 103TF0000X Psychologist, Family (Licence: MN LP0162) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |